How do Fitness to Practise hearings work?

The GMC - which brings the case against the doctor - and the doctor are both invited to attend. The GMC is normally represented at the hearing by a barrister and the doctor is usually present and legally represented.

Both parties may call witnesses to give evidence and if they do so the witness may be cross-examined by the other party. The Panel may also put questions to the witnesses.

The Panels meet in public, except where they are considering confidential information concerning the doctor’s health or they are considering making an interim order.

The Panel's decision

Once the Panel has heard the evidence, it must decide:

whether the facts alleged have been found proved

whether, on the basis of the facts found proved, the doctor’s fitness to practise is impaired

if so, whether any action should be taken against the doctor’s registration.

If the Panel concludes that the doctor’s fitness to practise is impaired, the following sanctions are available:

to take no action

to accept undertakings offered by the doctor provided the panel is satisfied that such undertakings protect patients and the wider public interest

to place conditions on the doctor’s registration

to suspend the doctor’s registration

to erase the doctor’s name from the Medical Register, so that they can no longer practise.

The guidance aims to ensure consistency of decision-making and has been welcomed by the courts which hear appeals against decisions taken by panels.

Warnings

If a Panel concludes that the doctor’s fitness to practise is not impaired, it may issue a warning to the doctor.

But in order to do so the panel must be satisfied that there has been a significant departure from the standards set out in Good Medical Practice or where there is cause for concern following an assessment of the doctor’s performance.

Standard of proof and judgment

Where the Panel makes a finding on disputed facts, it applies the civil standard of proof.

Where the Panel decides whether or not the doctor’s fitness to practise is impaired, it uses its judgment. The same is true when the Panel decides what sanction should be imposed on the doctor.

The Panel must be satisfied that any proposed action is sufficient to protect patients and the public interest.

Appeals

Doctors have a right of appeal to the High Court (Court of Session in Scotland) against any decision by a panel to restrict or remove their registration.